Koro Syndrome: Epidemiology, Psychiatric and Physical Risk Factors, Clinical Presentation, Diagnosis, and Treatment Options

Abstract

Koro syndrome is a multi-tiered disease presenting as an overwhelming belief that one’s sex organs are shrinking into their body. Moderate to severe anxiety attacks are associated with the condition, along with a fear of imminent death. Koro is often culturally related and is most seen as an epidemic form in East and Southeast Asia, although it can present anywhere worldwide in its sporadic form. The condition typically affects young males who believe in sex-related myths, and many individuals can co-present with anxiety, depression, or even psychosis. Although most presentations of Koro are self-limiting, the condition is harmful for one’s self-esteem and quality of life, and some individuals may go through extreme, physically injurious measures to prevent genital retraction. Treatments include the use of psychotherapy that has a sex education component, especially if the patient believes in culturally rooted myths. In sporadic Koro, it is believed that if the primary psychiatric disorder is treated with anxiolytics, antidepressants, sedatives, or psychotics, the secondary Koro-like symptoms will also fade. Additional investigation on the prevalence, pathogenesis, factors that correlate with treatment efficacy are needed to fully understand Koro syndrome.

A Rare Presentation of Delusional Parasitosis With Koro-Like Syndrome

“…However, the scarcity of literature and case reports presents a challenge in identifying the most effective pharmacological approach for addressing the co-occurring delusional parasitosis and Koro-like syndrome. Anxiolytics, antidepressants, sedatives, or antipsychotics might be recommended based on the patient's accompanying psychiatric conditions, if relevant, as improvement in these conditions often aligns with the alleviation of Koro symptoms [9]. These pharmacological interventions primarily aim at addressing the underlying psychiatric conditions.…”

“…Koro syndrome is a psychiatric disorder characterized by an intense fear of genitalia retracting into the body, potentially leading to death. In males, this fear centers on the penis shrinking into the abdomen, while in females, it involves the vulva and breasts shrinking into the abdomen and chest [9]. It is categorized into two types: endemic and sporadic.…”